Head Injury Risks from Overhead Luggage

The AirSafe Journal
Issue 13 - 7 September 1999

In a study published in 1998 by the Flight Safety Foundation, Dr Leo Rozmaryn, an orthopedic surgeon and medical director of Workplace Dynamics, claims that head injuries caused by falling objects from the overhead storage bins can lead to brain injuries that can affect patients months after the initial trauma. Although the article focused on incident data involving passengers on 757 aircraft, the injury risks described in the article are likely present in many single aisle jet passenger aircraft such as the 737 and the A320. This article raises a number of important baggage related issues that should be of interest to every airline passenger or fight attendant.

Falling Baggage and Their Consequences

According to Dr. Rozmaryn's article, there are an estimated 4,500 incidents of injuries from falling baggage each year in the U.S. and about 10,000 such events worldwide. These injuries fall in two major categories: injuries to passengers and flight attendants from falling baggage and injuries to flight attendants from baggage handling. According to the article, baggage can emerge uncontrolled from overhead compartments if the contents shift in flight or if the compartments were loaded beyond their capacity.

Dr. Rozmaryn based his findings on a survey of 462 falling baggage events on the 757 aircraft of an unnamed major U.S. airline. Of these 462 events, which occurred during the mid-1990s, a person was struck in 397 cases. In those cases where a person was struck, there were 67 injuries involving bruising, 53 injuries involving lacerations, and 277 cases resulting in no injuries. More than 90 percent of the injury cases involved head injuries to aisle seat passengers.

Dr. Rozmaryn's analysis of the airline's documentation of these occurrences showed that the objects that fell from the overhead compartments were divided into five categories:

Briefcases, baggage, and other luggage;

Portable computers;

Wheeled luggage such as wheel-fitted carts, strollers and wheelchair parts;

Sporting goods; and,

Boxes, picture frames and oddly shaped items.

The overall injury rate from falling baggage was 30 percent for all classes of objects. Boxes, picture frames, and other oddly shaped items were the most likely to produce injuries with about 82 percent of these occurrences producing a bruising or laceration injury.

Medical Consequences

Dr. Rozmaryn identified minimal traumatic brain injury (MTBI) as the most serious medical consequence of these injury events. According to the article, a heavy item falling on a person's head may cause a brief loss of consciousness, headache, dizziness, clotted blood within the scalp tissue, abrasions, lacerations, or bleeding beneath the skin. After initial treatment, about 50 percent of MBTI victims develop postconcussive symptoms such as persistent headaches, dizziness, fatigue, irritability, ringing in the ears, reduced concentration, frustration, slowed thinking, sleep disturbance, memory dysfunction, anxiety, sensitivity to noise, double or blurred vision, sensitivity to light, and depression.

The lack of visible lacerations or immediate symptoms does not necessary mean that no injury has occurred. A significant number of patients may not show symptoms at first, and may worsen in the 48 hours after the initial trauma. Some studies cited in the article revealed that between 20 percent and 60 percent of patients have persisting symptoms three months following their injuries.

Flight Attendant Injuries from Baggage HandlingIn addition to discussing injury risks that passengers face from falling baggage, Dr. Rozmaryn's article also discussed the results of two airline surveys of flight attendant injuries related to baggage or baggage handling. At one airline studied, over an 18-month period, 100 flight attendant baggage-related injuries led to 2,704 lost work days with 68 of the injuries occurring while the flight attendant was loading bags overhead and 17 others occurring while the flight attendants were assisting passengers. At a small national airline, there were 66 total flight attendant injuries during 1996 with 10 of them related to baggage handling.